Cuomo signs marijuana law, says it offers balance

Governor Andrew Cuomo on Monday signed the Compassionate Care Act, making New York the 23rd state to legalize medical marijuana.

“There is no doubt medical marijuana can help people,” Cuomo said at the New York Academy of Medicine on the Upper East side, where he was surrounded by legislators, advocates and patients who might benefit from the drug.

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New York’s program allows marijuana to be administered to people with for illnesses including epilepsy, multiple sclerosis, A.L.S., Parkinson's disease, Huntington's disease, neuropathies, spinal cord injuries, cancer and HIV/AIDS. The health department must decide within 18 months whether to add new diseases or disorders to that list.

It is likely to take at least that long before the drug can get into the hands of those patients and it could take much longer depending upon the speed with which the state’s health department implements the law.

Regulations need to be written. Distributors need to be licensed. Doctors need to be trained. And the plant needs to grow.

Still, advocates were quick to point out that after a two-decade campaign, this was a historic step for the state of New York.

The bill was championed by Assembly health committee chair Richard Gottfried, who has fought for a medical marijuana law for the last 17 years, and State Senator Diane Savino, who pushed reluctant colleagues to support a law she said would be tightly regulated and provide relief to ailing New Yorkers.

Even as Senate leadership refused to commit the bill to a vote, Savino, a member of the Independent Democratic Conference, rounded up Republicans and outside organizations to support the measure, and threatened to use a procedural move to bring the bill to the floor if Senate Majority co-leader Dean Skelos refused to do so.

Cuomo stayed on the sidelines, offering faint praise for the idea but remaining vague on what exactly he wanted.

Only in the last few weeks, when it became clear the bill had more than enough votes in the Senate to pass, did Cuomo seek to put his stamp on the law.

The governor shaped a deal that kept the program under executive control. If the health department or police departments decide the program has resulted in a diversion of the drug for illegal purposes, the commissioner or state police superintendent can issue a recommendation to the governor to end the program immediately.

Even if the program is successful, the law has a built-in sunset provision: It will expire after seven years if the Legislature doesn’t take action to renew it. The bill does not allow smokable forms of the drug, which Cuomo believes will curb excess use.

Joseph Mercurio, a political consultant who mostly works with Democrats, told Capital after the bill passed last month that Cuomo’s insistence on prohibiting smokable forms of the drug was a “purely political” move to protect the campaigning governor—who is spoken of as a 2016 presidential possibility—from charges he is too liberal. However, the governor has said not allowing smokable forms of the drug is intended to keep marijuana from being used recreationally.

On Monday, Cuomo provided a window into his thinking on the matter.

“We want to help people,” he said. “However, you want to make sure you do it right. What made this complicated was that it deals with marijuana, and on the one hand it’s a great substance for medical advancements, and on the other, it is illegal for distribution. It is considered a gateway drug. We are dealing with a heroin epidemic that is frightening. It’s complicated and it required a nuanced approach and government isn’t good at nuance. The complexity and nuance are often more than government can deal with. In this situation, government legislated with nuance and balance.“

That meant the bill's champions had to give up a lot of what they had been fighting for to ensure there would be a bill signing ceremony where Cuomo could boast that this is one of the most tightly regulated medical marijuana laws in the country.

Patients must receive a certified form from a doctor trained to prescribe marijuana before they can receive the drug, and doctors must consult the state’s prescription monitoring drug program registry to look at a patient’s prior history of receiving controlled substances, before making a determination of whether or not to prescribe medicinal marijuana.

Patients and certified caregivers are allowed to possess a 30-day supply of the drug at any given time, and any patient who knowingly obtains, possesses, stores or maintains an amount of marijuana in excess of the amount could be found guilty of a Class A misdemeanor.

Any manufacturer seeking a license to grow the drug will have to meet a series of qualifications, under the direction of the state’s health department and its commissioner. The applicant also has to demonstrate it can maintain security.

The law also stipulates that only five manufacturers will be licensed to grow marijuana. As many as 20 dispensaries would be able to carry the drug for sale.

This could represent the law’s greatest challenge. A governor wary of the excesses of marijuana and a tightly regulated program could make it hard for dispensaries to effectively operate.

New Jersey’s medical marijuana program, signed into law in 2010, has barely gotten off the ground and has been thwarted by administrative hurdles.

“Of course that’s a concern here,” said Gabriel Sayegh, New York State director for the Drug Policy Alliance. “That’s why the implementation is the key piece we need to stay focused on.”

This is not the bill Sayegh and many other advocates had pushed for. It is far more restrictive and tenuous. It does not allow all forms of marijuana and restricts the number of diseases for which the drug can be prescribed, but after two decades of fighting for some form of medical marijuana there was enthusiasm on Monday that the law was a foundation upon which to build.

“If we didn’t think the bill could be workable for patients we'd say so,” Sayegh said. “Given what we were up against and given the challenges … it is a big deal that this bill was signed, if it is implemented effectively. We don’t want to end up with the same issues the folks of New Jersey have to face … We know that overly restrictive regulatory process can leave patients waiting.”

Other advocacy groups wete not so diplomatic.

Americans for Safe Access released a statement saying New York's law deserved an "F."

"Advocates have voiced concerns over the law's 7-percent tax, and a prohibition on access to whole-plant cannabis," the statement said. "Advocates have also raised concerns over the prohibitive cost for many patients who cannot afford to purchase what would otherwise be an inexpensive medicine to grow."

About a dozen patients attended Monday's press conference in Manhattan. Some were in wheelchairs, some were children barely old enough to speak. They were a reminder of who the bill is intended to help, but also a reminder of how long these patients might have to wait for marijuana.

Gottfired said his work is not over. He is going to try and amend state law so New York could legally import medical marijuana from other states that have an already up-and-running program. That would need explicit approval from the Cuomo administration and at least tacit approval from the U.S. Department of Justice, which is supposed to prosecute the trafficking of marijuana over state lines.

“Anything that helps get the drug more quickly into the hands of people who need it is a mitzvah,” Gottfried said.

The law also calls for the state’s health commissioner to decide within 18 months of the bill’s enactment whether to include several other diseases under the umbrella of what the drug can be prescribed to treat, including Alzheimer’s, muscular dystrophy, dystonia, post-traumatic stress disorder and rheumatoid arthritis.

The state health department did not immediately respond to questions about Cuomo’s other medical marijuana plan. In January, the governor announced a research program to study the efficacy of medical marijuana, how best to distribute the drug and who would be most likely to benefit from its use. That might seem redundant in the face of this new statute but Gottfried, who is also unaware of the pilot program’s fate, said he hopes it does go forward.